MEDICARE: JDB ENTERPRISES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0000X	Wound Care Registered Nurse

General Provider Information

NPI Number	:	1720896756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JDB ENTERPRISES LLC

Provider Business Mailing Address
First Line	:	2905 CAMERON ST STE B
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-3791
Country	:	US
Telephone Number	:	318-657-4555
Fax Number	:	318-312-5325

Provider Business Practice Location Address
First Line	:	1305 FOURTH ST STE B
Second Line	:
City	:	JONESVILLE
State	:	LA
Zip	:	71343-2123
Country	:	US
Telephone Number	:	318-657-4555
Fax Number	:	318-312-5325

Authorized Official
Title or Position	:	CEO
Name	:	LAUREN KING
Credential	:	FNP-C
Telephone Number	:	318-758-1529

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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Directions to “JDB ENTERPRISES LLC ” Practice Location

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